Near Miss in Nursing: Concept Analysis

Abstract

Background:Near misses in health care are valuable instances of opportunity to recognize and eliminate anticipated harm prior to its occurrence in the patient. Though extremely common, near misses in nursing practice are underreported, thus cutting their power as safety-improving tools. Objective: This concept analysis investigates the phenomenon of near misses in nursing through theoretical frameworks from Patricia Benner's "From Novice to Expert" and Faye Glenn Abdellah's "21 Nursing Problems." The aim is to define the concept, emphasize its attributes, and affirm its applicability to clinical safety and nursing development. Methods: A literature-based concept analysis was performed, synthesizing findings from scientific journals, international safety guidelines, and nursing theories. The analysis was organized into eight sections: definitions, attributes, antecedents, consequences, and example cases (model, borderline, and contradictory). Results: Five characteristic attributes of near misses were identified: recognition of risk, timely action, lack of harm, reflective practice, and adaptation at the system level. Antecedents of importance are an open safety culture, and consequences are augmented protocols and organizational learning. Theoretical consistency with Benner's and Abdellah's models supports experiential knowledge and systematic assessment of care. Practical instruments like Turnitin, Peergrade, and Moodle Workshop can facilitate documentation and learning from near misses by peers. Conclusion: Near misses play a crucial role in institutionalizing individual clinical experiences into system-wide changes. This discussion reflects the importance of a non-punitive reporting culture, interdisciplinary communication, and technology-enabled safety interventions. Considering near misses as drivers of innovation and learning reinforces their worth in fostering lifelong learning and reflective practice in nurses.